Friday, March 11, 2011

Child Development and Public Health

For the past week I’ve studied the evidences of multicontextual development (Berger, 2009) in children’s physical, mental, and emotional health. The consensus is that Public health measures are also dependent on various contexts, just as children’s health is influenced by contextual variables. Many scholars agree along with me that healthy children are a prerequisite for healthy communities and healthy societies. Public health measures are designed to contribute to children’s health. Nutrition/malnutrition, Immunization, Access to healthy water, Sudden infant death syndrome (SIDS), Breastfeeding, and Mental health of mothers, fathers, and families in general are just some of the concerns related to public health measures that impact children’s development.
I was asked to write about one of the public health topics and describe it’s meaningfulness to me.  I chose to write about malnutrition because of its personal relativity to the life of my son.  Prior to my son’s adoption, at the age of 6 months old, we had a very frightening episode happen.  My husband and I were putting on our coats to leave for church when the infant began to vomit—he had just been given a bottle 10-15 minutes prior.  The vomiting turned into choking and asphyxia, and he began to go unconscious.  I immediately called 911 and they guided me on what to do until the ambulance arrived.  The result of that night was a myriad of tests, esophageal surgeries, and a diagnosis of Gastro-esophageal Reflux Disease (GERD) from a dime sized hole in his esophagus.  This physical condition led to his later diagnosis, at age 9  months, as Failure-to-Thrive (Rabinowitz, 2010).
At the age of 9 months, the infant weighed 25 pounds (Iwaniec, 1985) and remained at that weight until the age of three years old.  The hypothesis of his condition (White, 2011) derives from the assumption that during his first three months of existence he experienced poor living conditions, inappropriate feeding due to lack of parental training (American Academy of Pediatrics [AAP], 2006), abandonment, and other associated contexts (Berger, 2009).
I understand that most of the time that we hear about malnutrition, it is in regards to third world countries, or deliberate parental neglect (AAP, 2006).  However, malnutrition in my son was the result of inability to intake calories of any sort without experiencing pain.  Indirectly, one might say that neglect played a part in his demise. I choose to say that multicontextual variables (Berger, 2009) of the biological parent resulted in her doing what she could with what she had.  On the surface, this is commendable; the undercurrent displays that her seeming best efforts were not good enough, and the costly consequence was the physical damage to the child’s biological development.
Today, the hole in his esophagus has healed; his current weight at age 5 is 37 pounds, for the past two years he has not had to take at least 3 of the 5 medications that he had been prescribed since his diagnosis, and his Occupational Therapy has been drastically reduced from four days a week. It is apparent to me that regardless of the challenges, my son has shown great resilience in overcoming many of his negative physical encounters.  Protective factors—supports and opportunities that buffer the effect of adversity and enable development to proceed—have changed the course of my son’s life for the better (Wested, 2004).


REFERENCE LIST

American Academy of Pediatrics (April 3, 2006). Failure to Thrive as Distinct from Child Neglect. Pediatrics, volume 117  (4th ed.). pp. 1456-1458 (doi: 10. 1542/peds. 2005-3043). Elk Grove Village, IL: AAP

Berger, K. S. (2009). The developing person through childhood (5th ed.). New York, NY: Worth Publishers

Iwaniec, D. [Dorota], Herbert, M. [Martin], and McNeish, A. S. (1985). Social Work with Failure-to-Thrive Children and their Families Part I: Psychosocial Factors. The British Journal of Social Work, volume 15 (Issue 3), pp. 243-259.

Rabinowitz, S. [Simon]. (2010). Nutritional Considerations in Failure to Thrive. In WebMD Professional online. Retrieved from http://emedicine.medscape.com/article/985007-overview

Wested. (2004). Resilience: A universal capacity. Retrieved from http://www.wested.org/online_pubs/resiliency/resiliency.chap1.pdf

White, C. (2011). Childbirth—In Your Life and Around the World [Blog message]. Retrieved from http://eleazar-lazaros.blogspot.com

3 comments:

  1. Cymantha,
    It is such a pleasure to hear that your son is overcoming many of his negative physical encounters. I believe he was put in your life for a reason. I also chose nutrition/malnutrition as my topic to discuss. My heart goes out to children, and it is very important that a child receive the good nutrition that is needed. The way the economy is now, many children will be suffering from not getting the proper nutrients needed for their bodies to grow and stay healthy. Our pre-k program is in jeopardy of going to an 4 hour program, and we as early childhood educators, are fighting to keep it open fulltime. Alot of our children don't have the opportunity to have a full balance meal- breakfast and lunch. Some even come in hungry saying they didn't get anything to eat the night before.With us living in an rural area, alot of assistance is not available. I applaud you for all you have done for your son, and also from reading your discussions and blogs, I feel you really have a passion and care about young children.

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  2. I am thankful your son is a thriving 5 year old and continues to improve. He is very lucky to have you in his life. Malnutrition and the proper nutrition is a problem and it's not only in countries outside of the U.S., but right here in our backyard. We have so many government programs for families to get the food they need and the medical attention. Unfortunately more often than not those programs are abused. I have made home visits and seen parents try to sell me their food stamp card. Although we have the food stamp program. Often times the food is bought for large family events with it and that leaves the children in the home without food for a month until more money comes in. Several times a year we discuss what we had for breakfast or dinner in my class. It breaks my heart. Many of my students will tell me noodles or cereal. I know they can buy more than that. Sometimes the only meal a child will get is the one at school. I would agree that mothers in other countries and some here do not have the means available to gain the nutrients their body needs to have a healthy child. I would also agree that they probably do the best they can with what they have. I can't imagine that there is a mother that would deliberately not eat or eat the wrong things while pregnant. Unfortunately I'm sure there are some.

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  3. I have learned this week that nutrition is a huge factor in development, both before and after birth. Ginny, I agree that sometimes food assistance is misused. I know the mother of one of my foster children routinely sold her food card for half of what it was worth, just so she could have cash for other things. Of course, at the time her child lived with me, so his nutrition wasn't in jeopardy. He did go to live with her for a few months, but luckily I was still buying his formula and giving it to her with his leftover WIC checks. I do know that a lot of families use the assistance appropriately, however, and it is so valuable for those families.

    Cymantha, your son is indeed lucky to have you! Our youngest adopted son used to choke after eating due to GERD, and it is scary. We had to use back blows for babies several times to get him to vomit so he could breath, as he often turned blue. I looked at school lunch programs for this assignment, and it's sad that most school's lunches don't provide the nutrition children need. It's great if a family can send their children to school with nutritious packed lunches, but many families rely on the reduced cost or free lunch program to feed their children during the day. This is a good area to keep knowledgeable about, and to help educate parents about as well.

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